Accident Prevention
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Please let us know your name.


Is there information to report for this period?
Is there information to report for this period?
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Accident Summary

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Were Incidents Reported to Gallagher Bassett?:
Were Incidents Reported to Gallagher Bassett?:
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Inspection Summary

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Preventative Measures

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General Compliance

Alcohol Service Policy Reviewed/Updated (Yes/No):
Alcohol Service Policy Reviewed/Updated (Yes/No):
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Kitchen/Equipment Safety Measures Enforced (Yes/No):
Kitchen/Equipment Safety Measures Enforced (Yes/No):
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Please provide receipts / images (if applicable).

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Comments & Requests

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